Pancreatic Lesion

I am a 60 yo woman who aquired HBV at birth. I started antivirals (ETV and then TAF) 3 years ago when my ALT started to rise although I always had a high viral load and remained HBeantigen positive. I wanted to start on meds earlier but my hepatologist at the time did not recommend it.
My viral load decreased significantly after starting on meds but then began to rise again but not into the millions as it was before. However thankfully it decreased in my last blood test (184) but still is not undectectable. My ALT though is still above normal levels (65). Perhaps it’s fatty liver but my BMI is 19.3 and my doctors tell me I need to put on weight so I’m trying to put on healthy weight. My diet is mostly low fat plant based but I’m trying to eat more as I exercise a couple of hours a day. I was also diagnosed with prediabetes last year so I’ve cut down as much as I can on processed foods and am trying to move after meals to burn off blood glucose.
I don’t drink alcohol, smoke or take recreational drugs.
My latest concern though is that in my most recent ultrasound a 1 cm lesion was found on the tail of my pancreas. The radiologist thinks it’s fat and my hepatologist is not that concerned but I am having an MRI next week to confirm. I am nervous as I have read that pancreatic cancer is linked with HBV. As well adult onset diabetes is a sign of pancreatic disease. Does anyone know of HBV patients with pancreatic cancer? I’m hoping for the best and trying not to fear the worse as stress wrecks havoc on my body. Thanks.

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Dear @wml,

Sorry to hear about this finding and all the anxiety it is causing you. I hope all the best with it.

I just want to go over the reported numbers of pancreatic cancer. It is quite low, US numbers are something around 1.6% for lifetime risk of pancreatic cancer. Some reports on large populations of people with pancreatic caner have suggested a 25% increased risk of HBV patients getting pancreatic cancer (still really unclear what this association might be due to), which equates to a risk of 1.9%, still very low.

Easier said than done, but it’s worth it to wait for the MRI results before panicking too much about it. You are doing all you can to get yourself the best care.

Wishing upon you all the strength you need to get through this.

Yours sincerely,

Thank you Thomas for these statistics. It’s good to see that the risk is low for developing pancreatic cancer. It’s sad that HBV is linked to it as well. It’s hard enough that HBV puts us at high risk for HCC. I did not know that it lead to an increase of PC albeit not a huge risk.
Thanks for your good wishes. I need all I can get!

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Hi wml
I have read your work with lot of understanding and empathy as a person who has just had liver resection due to hepb related HCC.
I would advice you not to panic alot from the unknown.

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Hello Kinoti
Thank you for your kind words. I am sorry to hear about your HCC but it’s hopeful that the affected area of your liver was able to be resected. My mom died of HCC when she was only 66 years old and it was not detected until it was inoperable.
Wishing you a full recovery and a cancer free future.

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Hi wml
I am happy to hear your prayer for me. I am also happy to know quite a big number of hep b community members appreciate my contribution in the forum. God sents me ahead of many of us so that I can be of encouragement.
After liver resection a contrast enhanced CT scan confirmed everything was removed. A biopsy examination placed my fibrosis at 4 kPa which is ,encouraging.